Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 90869 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Tcran Magn Stim Redetemine, Transcranial Magnetic Stimulation Treatment (Stimulates Nerve Cells In Brain To Improve Symptoms Of Depression) Subsequent Motor Threshold Re-Determination With Delivery And Management
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Psychiatry Services and Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 59 - Distinct Procedural Service 22 - Increased Procedural Services |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 90869 |
| Medicaid Fee Schedule | $155.73 median of the 8 states in the free preview · View Medicaid rates for 90869 |
National average reimbursement for CPT 90869 by major payers:
$381.58
$389.23
$296.83
$445.79
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 90869.
CPT 90869
5 of 25 sample ratesHigher to lower in this preview
Mark Alter
Virginia Mason Medical Center
$565.53Published rateJohn Berlin
Christiana Care Health Services Inc
$411.10Published rateMark Alter
Tri-State Memorial Hospital
$357.48Published rateTimothy Newell
Mainehealth
$352.02Published rateSylvia Boules
Psychiatric Care Systems
$252.35Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 90869 vs. Other Psychiatry Services and Procedures Codes
The CPT 90869 code is part of the Medicine Services and Procedures services used for Psychiatry Services and Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 90869 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 90865-CPT | Low | Psychiatric Interview, A Psychiatrist Interviews A Person After They Have Been Given Sodium Amobarbital (Amytal) To Induce A Hypnotic State. The Drug Helps To Access Repressed Memories. Drug Effects Are Monitored Overnight. |
| 90867-CPT | Moderate | Brain Stimulation Planning, Treatment Planning For Tms (Transcranial Magnetic Stimulation) A Technique For Gently Stimulating The Brain Using Magnetic Pulses. Tms Is A Treatment For Depression And Anxiety. |
| 90868-CPT | Moderate | Brain Activity Stimulation, Tms (Transcranial Magnetic Stimulation) Treatment A Technique For Gently Stimulating The Brain Using Magnetic Pulses. Tms Is A Treatment For Depression And Anxiety. |
| 90869-CPT | Moderate | Tcran Magn Stim Redetemine, Transcranial Magnetic Stimulation Treatment (Stimulates Nerve Cells In Brain To Improve Symptoms Of Depression) Subsequent Motor Threshold Re-Determination With Delivery And Management |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90869. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90869 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 90869) and we'll show you how you compare in 15 minutes or less.